How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $117.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $117.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | None | $107.15 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS New Mexico Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $4,265.80 | Facility | None | $776.25 | $2,754.23 | $4,265.80 |
BCBS New Mexico Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $208.93 | Professional | None | $75.86 | $131.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $1,202.26 | Facility | None | $114.82 | $158.49 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $229.09 | Professional | None | $123.03 | $165.96 | $229.09 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $123.03 Typical High $204.17 | Professional | None | $24.55 | $123.03 | $204.17 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $169.82 Typical High $1,288.25 | Facility | None | $114.82 | $169.82 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $239.88 | Professional | None | $123.03 | $165.96 | $239.88 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $251.19 | Professional | None | $123.03 | $173.78 | $251.19 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $77.62 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $41.69 | Professional | 53 · Discontinued | $22.91 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $85.11 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $31.62 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $144.54 |
Where New Mexico sits
The same service costs 4.0 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 27th of 51
$166
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.